| Doctor Name: | MS. MARYBETH A BEAVER |
| NPI Number: | 1295047223 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN, ANP-BC |
| License Number: | 26NJ0005400 |
| Business Practice Address: | 485 Williamstown Rd Sicklerville, NJ - 080811777 |
| Business Phone Number: | 8562378100 |
| Business Fax Number: | 8562378042 |
| Mailing Address: | 485 Williamstown Rd, SICKLERVILLE |
| State: | NJ |
| Postal Code: | 080811777 |
| Phone Number: | 8562378100 |
| Fax Number: | 8562378042 |
| NPI Enumeration Date: | 07/07/2010 |
| NPI Last Update Date: | 05/12/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | 26NJ0005400 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |